CMS Improves Internet-based PECOS

Based on stakeholder feedback obtained over the last year, the Centers for Medicare and Medicaid Services (CMS) has made improvements to the Provider Enrollment, Chain, and Ownership System (PECOS), which allows most providers and suppliers to enroll in the Medicare program or make changes to their Medicare enrollment information via the Internet rather than through the paper form. The following upgrades aim to make PECOS more user-friendly:

Providers/suppliers now can submit their entire enrollment application including supporting documentation electronically with the new digital document feature. Hard copies of supporting documentation to the Medicare Administrative Contractors are no longer required.

Individual providers who reassign benefits to individuals/organizations with multiple practice locations will be able to designate a primary and secondary practice location where services are rendered. Selecting a primary and secondary practice location does not restrict the provider from providing services at other practice locations associated with the individual/organization to which they are reassigning benefits. It is recommended that a primary and secondary practice location be specified, but it is not required.

Providers/suppliers now can enter multiple contact persons in the contact information section and will have the ability to identify the contact's relationship to the provider/supplier. While Internet-based PECOS requires at least 1 contact person to be entered in this section, additional contacts and the relationship to the provider field are optional.

At least 1 managing employee now will be required when submitting a CMS 855A, CMS 855B, and CMS 855S enrollment application. Applications that do not include at least 1 managing employee will receive an error message in Internet-based PECOS under the error/warning check tab and will not be able to proceed with submitting the enrollment application. Internet-based PECOS also will recommend that at least 1 owner is entered for a CMS 855A, CMS 855B, and CMS 855S application. Applications that do not include at least 1 owner will receive a warning message under the error/warning check tab in Internet-based PECOS. This warning message will not prevent the user from submitting the enrollment application.

Providers/suppliers now will have the option to select "county" in the "geographic location" topic when identifying the geographic location where services are rendered for CMS 855A and CMS 855B enrollment applications. Prior to this feature the only available options were state, city, or zip code. When selected, Internet-based PECOS will populate the county field with all counties that exist within the enrollment state identified for the application.

CMS has redesigned the CMS 855O paper application, which is used to enroll in Medicare solely to order and refer services, and those changes are reflected in Internet-based PECOS. Providers who are currently enrolled in Medicare and are of a specialty that is eligible to order and refer already have the ability to order and refer services. Therefore, they are not required to submit a separate CMS 855O enrollment application solely to order and refer services.

APTA members can find more information about the program on the association's PECOS webpage.